This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards.
"The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale

Friday, 2 July 2010

Hospital Staff Nurse Interviews Hospital Administrator

10 comments:

Tee Hee :0DUnfortunately also too close to the truth. How do they sleep at night...on big piles of money. The Blue Rinse brigade should be camped outside of Tweedledum and Tweedledees big fat office demanding better treatment. Not that it will matter. Healthcare is expensive and no one wants to pay.

no chance of promotion even when you are doing the work of a senior and doing the jobs of 10 people because of intentional short staffing.

Meanwhile back at the ranch the vicky pollards are blowing all of their money on booze and fags while demanding 100& comprehensive excellent standards of health care with "customer service" to boot.

And managers and chiefs are getting pay rises and creating £100,000 a year "Patient Journey Champion" jobs for their buddies.

Fuck this shit. Hope my spouse stops dragging his feet about immigrating. I want to get paid for the hours I work, get paid based on the level of responsibility I have, get paid something rather than nothing when I am forced to work overtime and I want health insurance benefits.

Seriously, if one more jackass who only works an 8 hour day WITHOUT life and death responsibility calls me lazy because I didn't answer his call bell fast enough when my other patient as in full blown arrest I am really going to snap!!!!

"But my taxes pay your wages"

Um. No. I pay taxes too, and my unpaid hours and abusive working conditions help to cover the shortfalls that your taxes don't cover.

Lets hope that someone in Whitehall actually sits down and does the unthinkable and actually THINKS...can the NHS really carry on being "free" at the point of entry? The average cost of an NHS patient today is way more than 20 years ago...expensive new drugs and treatments that NI contributions cannot hope to keep up with. So we carry on regardless providing substandard care despite spiralling costs. When I worked in Switzerland, my private healthcare costs per month were less than I pay in NI today...and thats before I factor in what I spend on dentist and optician appointments. In the US it was also less (although as I had gone out with an agncy my insurance was subsidised). Big problem would be how to make sure that no-one falls through the cracks. Plus we would have to stop EDs becoming GP substitutes for those with no insurance. Biggest problem in this country is alcohol abuse...and not just your meth-swilling or chav stereotypes. More and more we are seeing supposedly sensible middleclass types who think that downing a bottle of vino a night is ok. We have a long history of aclohol abuse in the UK. Its about time we took it off the supermarket shelves and put it back into off-licences.

"can the NHS really carry on being "free" at the point of entry? The average cost of an NHS patient today is way more than 20 years ago...expensive new drugs and treatments that NI contributions cannot hope to keep up with. So we carry on regardless providing substandard care despite spiralling costs. When I worked in Switzerland, my private healthcare costs per month were less than I pay in NI today...and thats before I factor in what I spend on dentist and optician appointments. In the US it was also less (although as I had gone out with an agncy my insurance was subsidised"

I tried to tell a group of people this excat same thing during a debate and they called me a liar. You tell people this and they will turn into wildcats.

I too had cheaper health care abroad and better care abroad...in the US. Two of my kids have permanant health problems because of the NHS. I can't get them to a dentist. I took them to a dentist last time we visited the US. I got a same day appointment for both children with a very popular dentist there and all said and done the grand total was $200. I'd rather than then the high taxes, low wage, and two years we have been waiting for a dentist in this hellhole.

My view might be skewed though. The state I spent time in was a weathly northern one, that left no one with out care. They had great state programs for the uninsured. We had this huge child and adolescent psyche hospital...beautiful facility. I don't think any of the patients treated by that place came from wealthy insured families, yet it provided excellent in and outpatient care.

Best healthcare in America in that region supposedly. When I was a poor nursing student I had to go and get treated in the ER. Never got a bill.

Had I lived in a crap state like texas and then moved to a nice area of the UK my viewpoint might be entirely different.

But as it stands I really do believe that the NHS is primarily an epic fail. A good idea that was used and abused.

In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.

Why has Nursing Care Deteriorated

Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.

About Me

I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions.
I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS.
Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.

Quotes of Interest. Education of Nurses.

Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.

THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES

Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.

Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.

Registered Nurse Staffing Ratios

International Council of Nurses Fact Sheet:

In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.

A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)

Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.

Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications

•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)

Disclaimer

I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am. Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.